BCFD Volunteer Online Application Form

Th​e​ Bridge Creek Fire Protection District is an Equal Opportunity Employer and does not discriminate on the basis of race, color, religion, sex, national origin, age, marital, political affiliation, handicapped status or any other legally protected status. Please complete all questions with the asterisk clearly and completely. All questions must be answered. This is an application for a volunteer position and no employment contract is being offered. Volunteer firefighter applicants must be at least 18 years of age.

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Home Phone Number *

Work Phone Number *

Cell Phone Number *

Are you at least 18 years of age? *

YesNo

Age *

Sex *

Social Security Number *

Include dashes between numbers. Example: 123-45-6789

Height *

Weight *

In the event this information becomes invalid, please list the following information of the nearest relative through whom you may be reached.

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Education

Have you received a High School Diploma? *

YesNo

College Hours *

Did you receive a degree? *

YesNo

Education *

Some High SchoolCompleted High SchoolSome CollegeAssociate's DegreeBachelor's DegreeMaster's DegreePhD

Employment History

Present Employer Information

Name *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Name of last employer and reason for leaving *

References

List two (2) references that you have known for
more than five (5) years

Name *

First

Last

Phone Number *

Name *

First

Last

Phone Number *

Traffic Record

List all charges in which you have been arrested or received citations for (Excluding Parking Tickets) *

Has your driving privilege in this, or any other state, ever been suspended, revoked, or canceled? *

YesNo

If yes, explain *

Driver's License

Do you currently hold a valid Driver’s License? *

YesNo

License number *

Expiration date *

Other *

License class *

Restrictions *

Firefighting History

Do you have any firefighting experience? *

YesNo

What firefighting schools or classes have you attended? *

Do you have any disabilities that would hinder you from performing your duties? *